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Leadership

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The process of influencing people to accomplish goals

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What influences people

answer

character and integrity

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Framework for most leadership research prior to mid-1940s

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Great Man & Trait Theories: "Some people are born to lead" and a certain set of personality traits of great leaders could be described

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Great Man & Trait Theories

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"Some people are born to lead" and a certain set of personality traits of great leaders could be described

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Behavioral Theories

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Autocratic or Authoritarian; Democratic, Participative or Shared; Laissez-Faire, Permissive or Free Rein

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Autocratic or Authoritarian Leader

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Task-oriented, control over group, downward communication, decisions made by leader, emphasis on status, punitive

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Democratic Leader

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less emphasis on control, motivate by ego and economic rewards, direction by suggestions, foster 2-way communication, group decision-making, emphasis on "we"

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Laissez-Faire Leader

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permissive, little control, little or no direction, emphasis on people, free communication, dispersed decision-making, no criticism

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Transformational Leadership

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ability to look at what the group has in common; identifies common values, is committed, has long-term vision, inspires others with vision, and empowers others

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Law of situation

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developed by Mary Follet; Leadership style should vary based on situation/individuals involved. Situation should determine directives given after problem known by everyone.

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Leadership process (defined by Hersey)

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a function of the leader, the followers, and situational variables.

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Management (defined by Marquis-Huston)

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the process of leading and directing all or part of an organization through the deployment and manipulation of resources

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Scientific Management theory

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developed by Taylor; uses the scientific method to organize work—one best way to complete tasks; emphasis on productivity; workers viewed as "economic animals" and did not consider "human element"

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Classical management theory (Bureaucracy)

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developed by Weber; formal authority, chain of command, consistent rules and regulations, "structure"; presumed >efficiency was achieved through rules/regs

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Hawthorn Effect

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identified by Mayo in study on workplace physical and environmental influences on workers' productivity and motivation; demonstrated that workers are more productive when they know they are being observed

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The Management Process

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developed by Fayol; Planning > Organizing > Staffing > Directing > Controlling

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Planning stage of management process

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determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change

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Organizing stage of management process

answer

establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.

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Staffing stage of management process

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recruiting, interviewing, hiring, orienting staff, scheduling, staff development, employee socialization, and team building.

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Directing stage of management process

answer

human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration

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Controlling stage of management process

answer

performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control

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Human Relations Management

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developed the concepts of participatory and humanistic management, emphasizing people rather than machines

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Theory X and Theory Y

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developed by McGregor; assume that managers role is to gather the necessary resources (including people) to meet organization goals

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Theory X managers

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believe that their employees are basically lazy, need constant supervision and direction and are indifferent to organizational needs

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Theory Y managers

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believe that their workers enjoy their work, are self-motivated, and are willing to work hard to meet personal and organizational goals

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Contingency approach

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developed by Fred Fieldler; relationship between followers and leaders influenced by manager's ability to lead well

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Interactional leadership theory

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leadership behavior is generally determined by the relationship between the leader's personality and the specific situation

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Theory Z

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consensus decision making, fitting employees to jobs, job security, slower promotions, examining long-term consequences, quality circles, guarantee lifetime employment, establishment of strong bonds of responsibility, and holistic concern for workers

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Transformational leadership vs. Transactional

answer

transactional leaders focus on tasks and getting the work done. Transformational leaders focus on vision and empowerment.

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Full-range leadership theory

answer

suggests that there are nine factors impacting leadership style and its impact on followers; five transformational, three transactional, and one nonleadership

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Servant Leadership

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developed by Greenleaf; to be a great leader, one must be a servant first

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Principal Agent Theory

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interactive leadership theory that suggests that not all followers (agents) are inherently motivated to act in the best interest of the principal (leader or employer)

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Human capital theory

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suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have further payoff

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Human capital vs. social capital

answer

human capital represents the capability of the individual. Social capital represents what a group can accomplish together.

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Emotional intelligence

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the understanding and recognition of oneself and others' abilities, perception and attitudes

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5 components of emotional intelligence

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self-awareness, self-regulation, motivation, empathy, social skills

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Authentic leadership

answer

in order to lead, leaders must be true to themselves and their values and act accordingly

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Congruent leadership

answer

a match between the activities, actions, and deeds of the leader and the leader's values, principles, and beliefs

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5 distinguishing characteristics of the Authentic Leader

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purpose, values, heart, relationships, self-discipline

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Thought leadership

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a person who is recognized among their peers for innovative ideas and who demonstrates the confidence to promote those ideas

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Quantum leadership

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builds upon transformational leadership and suggests that leaders must work together with subordinates to identify common goals, exploit opportunities, and empower staff to make decisions for organizational productivity to occur

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Cultural bridging

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seeks out and respects other view points and creates a work environment where cultural differences are recognized and valued

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Industrial age leadership vs. relationship age leadership

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industrial age focused primarily on traditional hierarchical management structures, skill acquisition, competition, and control. Relationship age focused primarily on the relationship between the leader and followers.

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Leaders vs. Managers

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leaders not always formal, have wider variety of roles, and people focused. Managers are always assigned formal position, have legitimate source of power, have specific role responsibilities, and focus on control/use of resources

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Integrated Leader/Managers

answer

developed by Gardner; think longer term; look outward; influence others beyond own group; emphasize vision, values, and motivation; politically astute; think in terms of change and renewal; empower others

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Baby Boomers vs. Generations X and Y

answer

boomers view long hours as evidence of loyalty and hard work, Gen X and Y try to have more work/life balance (flexible hours, more vacation time, continuous training, and telecommuting options) by leveraging technology to work more efficiently

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Two keys areas of personal growth and development that are fundamental to leadership success

answer

self-confidence, and a positive attitude

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Lateral transfer

answer

one staff person moving to another unit, to a position with a similar scope of responsibilities, within the same organization

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Downward transfer

answer

someone takes a osition within the organization that is below his/her previous level

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Accommodating transfers

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allow someone to receive a similar salary but with a reduction in energy expenditure

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Inappropriate transfer

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solving unit personnel problems by transferring problem employees to another unsuspecting department

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Steps to Personal Goals Setting

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create "big picture" and identify large-scale goals; break goals down into smaller and smaller targets; then start working on achieving goals

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SMART Goals

answer

S - Specific (or Significant); M - Measurable (or Meaningful); A - Attainable (or Action-Oriented); R - Relevant (or Rewarding); T - Time-bound (or Trackable)

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ANA/NCSBN definition of delegation

answer

the process for a nurse to direct another person to perform nursing tasks and activities

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Delegation process

answer

identify task, indentify skills and levels, select most capable/appropriate person, communicate goal, empower the delegate, set deadlines, monitor progress, provide guidance, evaluate performance, reward accomplishment

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5 rights to delegation

answer

right task, right circumstance, right person, right direction/communication, right supervision/evaluation/follow-up

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Criteria for delegation

answer

must assess, task must be delegated using sound nursing judgment, can be performed safely, instructed UAP or verified competency, doesn't require licensed person, adequately supervise, periodically evaluate

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Ineffective delegation

answer

under delegation, over delegation, improper delegation, reverse delegation

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Causes of under delegation

answer

false assumption that delegation may be interpreted as a lack of ability; desire to complete the whole job personally due to lack of trust in subordinates; lack of experience; failure to anticipate the help needed; difficulty assuming the manager role

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Causes of over delegation

answer

poor time management; insecurity in ability to perform task

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Causes of improper delegation

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delegating at the wrong time, to the wrong person, or for the wrong reason; delegating tasks and responsibilities beyond the capability of the person being delegated to or that should be done by the manager

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Causes of resistance to delegation

answer

failure to see subordinate's perspective; lack of knowledge, information, skill or ability; fear of failure; resistance to authority; over-delegation of tasks; lack of positive incentives for motivation

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Nationally established standards for UAPs

answer

there are none

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Problem-Solving and Decision-Making Process Similarities

answer

define the problem, gather information, analyze information and explore alternatives, develop solutions, make a decision, implement, and evaluate

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Problem-Solving and Decision-Making Strategies

answer

trial and error; experimentation; past experience; intuition

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Problem solving styles

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Adaptation-Innovation Theory; Adaptors; Innovators

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Adaptation-Innovation Theory

answer

problem solving strategy that suggests two types of problem solvers: Adaptors and Innovators.

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Adaptors

answer

use tried and accepted ways, rarely challenge rules, methodical efficient, and less risk-taking

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Innovators

answer

seek solutions in creative and challenging ways; think 'outside the box'; promote change; higher risk-taking

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Creative Problem Solving principles

answer

deferred judgment (suspending bias, judgment, and evaluation) and divergent-convergent thinking (being open to exploring possibilities)

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Intuitive Problem Solving Novice Nurses vs. Experts

answer

Novice nurses rely more on deliberate thinking while experts rely more on instinct and "gut" feelings and looking for patterns.

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"thin slicing" (Gladwell, 2005)

answer

how experts draw on years of experience and a deep knowledge of their field to make rapid decisions using the thinnest slice of information

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Group Problem Solving Disadvantages

answer

can become so stagnant that they don't allow new ideas and generate change

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Risky Shift

answer

a group is willing to take greater risks than individuals would do on their own (e.g., mob mentality)

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Frequent Errors in Decision Making & Problem Solving

answer

failing to consider possible outcomes; lacking a clear objective or goal; faulty data gathering (information withheld or not ample); limiting options; faulty logic (over-generalizing); excessive delay; refusal/failure to act

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Satisficing vs. Maximizing

answer

satisficing is 'good enough for now' while maximizing must be done well initially

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Types of decisions

answer

routine (well-defined, common issues), adaptive (need modifications to usual methods), innovative (unusual problems needing creative solutions)

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Rational or Normative Decision-Making Model

answer

have good information and anlysis-allows for logical decision making

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Descriptive or Bounded Rationality Decision-Making Model

answer

fairly complete info but limited by time, energy, and or money or other resources

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Political Decision-Making Model

answer

considers needs of stakeholders and 'Power Brokers'

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Critical Thinking

answer

aka reflective thinking; "a set of cognitive skills" including "interpretation, analysis, evaluation, inference, explanation, and self-regulation"

question

Communication

answer

the complex exchange of thoughts, ideas, or information on at least two levels: verbal and nonverbal

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Goal of communication

answer

to approach as closely as possible a common understanding of the message sent and the message received

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Variables affecting organizational communication

answer

spatial distance; different subgroups or subcultures; differing authority and status; work structure; organizations in a constant state of flux

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Channels of communication

answer

downward (primarily directive), upward (allows employee input), lateral/horizontal (between individuals or departments at same level), and diagonal (between individuals or departments at different levels)

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Assertive communication

answer

allows people to express themselves in direct, honest, and appropriate ways that DO NOT INFRINGE ON ANOTHER PERSON'S RIGHTS

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Passive communication

answer

occurs when a person suffers in silence, although he or she may feel strongly about the issue; a nonassertive and manipulative way to send a message

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Aggressive communication

answer

expressing oneself in a direct and often hostile manner that infringes on another person's rights; generally oriented to a "winning at all costs" mentality

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Passive-Aggressive communication

answer

an aggressive message presented in a passive way; limited verbal behavior with incongruent nonverbal behavior

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SBAR

answer

a technique used to improve the communication between members of the health care team: Situation, Background, Assessment, Recommendations

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Communication process

answer

the person who is the source of the communication encodes it into a message, and transmits it through a channel. The receiver decodes the message, and, in one way or another, feeds back understanding or a lack of understanding to the source.

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KISS principle

answer

Keep It Simple and Straightforward

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Advocacy

answer

helping others to grow and fulfill their potential

question

Nursing values central to advocacy

answer

right to autonomy, right to hold personal values, access to information, act on behalf of clients who are unable to advocate for themselves, empowerment of patients and subordinates to make their own decisions

question

Advocacy vs. Paternalism

answer

advocacy is assisting patient choices (allowing freedom) vs. Paternalism is controlling patient choices (domination and dependence)

question

Subordinate advocacy

answer

manager helps resolve ethical and job related problems and live with the solutions at the unit level

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Workplace advocacy

answer

part of subordinate advocacy; ensuring the work environment is both safe and conducive to professional and personal growth for subordinates

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Failure to Rescue

answer

poor outcome of care that occurs when staff fail to identify potential complications early and take appropriate actions

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What is needed to rescue patients

answer

competent staff (critical thinkers); enough staff to spend time with patients; ability to mobilize resources

question

Interacting with the media

answer

respect/meet deadlines; assume will be fair/ accurate; have key facts/figures ready; limit key points to 2-3 bullet points; avoid technical jargon; speak confidently and truthfully; avoid inflammatory arguments or blame setting; provide contact info

question

Formal dimensions of power

answer

Relational Aspect, Dependency Aspect, Sanctioning Aspect

question

Relational aspect of power

answer

suggests power related to relationships between 2 or more individuals

question

Dependency aspect of power

answer

particularly evident in organizations; interdependence between units/staff

question

Sanctioning aspect of power

answer

direct manipulation of another's outcome (rewards, punishments, peer pressure)

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Reward power

answer

giving something of value (praise, pay raise, promotion)

question

Punishment (coercive) power

answer

force against the will; ability to threaten punishment and deliver penalties

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Legitimate power

answer

position power; right to command; authority; most common source of power

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Expert power

answer

unique skills/personal abilities

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Referent power

answer

subtle; based on admiration or respect for an individual or association with powerful others; comes from others

question

Referent power vs. charismatic power

answer

referent power is gained only through association with powerful others whereas charisma is a more personal type of power

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Informational power

answer

obtained when people have information that others must have to accomplish their goals

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Most common source of organizational conflict

answer

communication problems, organizational structure, and individual behavior within the organization

question

Categories of Conflict

answer

intrapersonal, interpersonal, intergourp

question

Stages of Conflict

answer

Antecedent/Latent, Perceived, Felt, Manifest, Aftermath

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Antecedent/latent conflict stage

answer

conditions exist (short staffing, poor pay, inadequate support)

question

Perceived conflict stage

answer

conflict recognized by individual (may be able to be resolved at this stage

question

Felt conflict stage

answer

emotionalized (anger/fear/mistrust)

question

Manifest conflict stage

answer

action is taken

question

Conflict aftermath stage

answer

positive or negative feelings linger (may be worse than original conflict if handled poorly

question

Competition strategy to resolve conflict

answer

One party pursues what it wants regardless of the cost to other person

question

Accommodation strategy to resolve conflict

answer

One party sacrifices his or her beliefs and wants, to allow the other party to win

question

Smoothing strategy to resolve conflict

answer

an individual attempts to reduce the emotional component of the conflict

question

Avoidance strategy to resolve conflict

answer

parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it

question

Compromise strategy to resolve conflict

answer

each party gives up something it wants

question

Collaboration strategy to resolve conflict

answer

an assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a common priority goal

question

When to intervene in a conflict

answer

the conflict gets to a place where it is creating a distraction, interference in workflow, or becomes a threat to patient safety or unit function

question

Alternative Dispute Resolution (ADR)

answer

mediation, fact finding, arbitration, due process hearings, and use of ombudsperson

question

Power

answer

that which enables one to accomplish goals

question

Power vs. authority

answer

power is the capacity to act whereas authority is the right to command

question

Power-building strategies

answer

personal energy, powerful persona, pay entry fee, determine powerful, learn culture, use org. priorities, increase skills/knowledge, broad vision, use experts/seek counsel, be flexible, be visible/have voice, toot own horn, sense of humor, empower others

question

Authority-power gap

answer

gap that sometimes exists between a position of authority and subordinate response

question

Planned change

answer

deliberate, intentional effort by change agent to create something new

question

Unplanned change or change by drift

answer

haphazard; random; unexpected; occurs over time as people enter/leave the system

question

Good reasons for change

answer

to solve some problem; to make work procedures more efficient; and to reduce unnecessary workload

question

Change agent

answer

persons skilled in the theory and implementation of planned change

question

Managers vs. Leaders

answer

managers continue the status quo while leaders embrace change

question

Lewin's Rules for Implementing Change

answer

should only be implemented for good reason; always be gradual; be planned and not sporadic or sudden; and all individuals who may be affected should be involved in planning for the change

question

Lewin's Change Theory steps

answer

unfreezing, movement, freezing

question

Lewin's Change Theory unfreezing stage

answer

must by pass defense mechanisms to change existing mind-set (assessment)

question

Lewin's Change Theory movement stage

answer

period when change happens; may be confusing and unsettling as old habits are challenged (planning and implementation)

question

Lewin's Change Theory freezing stage

answer

new mindset and habits stabilized; comfort levels return (evaluation/implementation)

question

Lewin's Force Field Model

answer

describes change as a dynamic balance of forces working in opposing directions within a field, such as an organization; for change to occur, forces (driving and restraining) must be altered

question

Driving forces

answer

facilitate change

question

Restraining forces

answer

impede change

question

Roger's Theory of Planned Change

answer

described 5 factors that determine successful planned change: relative advantage, compatibility, complexity, trialability, observability

question

Roger's relative advantage

answer

degree to which change is deemed preferable to status quo

question

Roger's compatibility

answer

degree to which change is compatible with groups existing values

question

Roger's complexity

answer

degree to which change is perceived as difficult to use/understand

question

Roger's trialabilty

answer

degree to which change can be tested on a limited basis

question

Roger's observability

answer

degree to which the results of a change are visible to others

question

reason people resist change

answer

lack of trust; also vesting interest in status quo, fear of failure, loss of status or income, misunderstanding, rigidity

question

Pesut responses to change

answer

individuals are either crusaders (innovators and early adopters) or tradition bearers (prefer status quo and/or may resist) in response to their propensity to seek change

question

Porter-O'Grady's single most important factor in how people accept change

answer

the manager's behavior

question

Audit

answer

systematic exam of a record, process, structure, environment or account to evaluate performance

question

Types of audits

answer

retrospective, concurrent, prospective (how future performance will be affective), outcome, process, and structure

question

Most common audits

answer

outcome, process, structure

question

Outcome audit

answer

what results occurred as a result of specific interventions (e.g., patient falls, hospital-acquired infections, pressure ulcers, restraints, patient satisfaction)

question

Process audit

answer

measures how nursing care was provided (e.g., efficient, best practice, how being carried out, policies/procedures being followed)

question

Structure audit

answer

looking at the patient care environment: structure (e.g., lighting, beds, flooring) and environment of care (e.g., staffing ratios, staffing mix, ED wait times)

question

Quality improvement

answer

target ongoing and continually improving quality

question

Quality assurance

answer

target currently existing quality

question

Total quality management

answer

never ending process, everyone can improve

question

Quality

answer

the degree to which services for individuals and populations increase the likelihood of desired healthcare outcomes and are consistent with current professional knowledge

question

Quality control

answer

activities that evaluate, monitor, or regulate services rendered to customers

question

Quality control vs. Risk management

answer

moved health care from a model of identifying failed standards, problems, and "problem people" (risk management) to Proactive organizations where problems are prevented and care improvements are continuously made (quality control)

question

Leapfrog Group standards

answer

CPOE system, evidence-based hospital referral, ICU physician staffing, Leapfrog safe practices

question

Number one cause of Sentinel Events

answer

poor communication

question

Workplace violence

answer

incident that leads one to believe that he/she has been harmed by the experience (e.g., favoritism, verbal abuse, abusive correspondence, bullying, pranks)

question

5 steps to handling patient complaints

answer

acknowledge the incident and apologize; quick follow-up; personal contact; immediate restitution; document facts

question

Organizational structure

answer

the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions

question

Span of control

answer

number of people reporting to one manager; optimal range is 3-50 depending on manager's expertise

question

Line Organizational Structure

answer

Bureaucratic designs found frequently in healthcare organizations

question

Ad hoc Organizational Structure

answer

modification of bureaucratic design sometimes used temporarily to facilitate project completing

question

Matrix Organizational Structure

answer

focused on both product and function; formal vertical and horizontal chain of command

question

Flat Organizational Structure

answer

more authority and decision making occurs where work is done

question

Organizational Climate

answer

system of symbols and interactions unique to each organization; ways of thinking, behaving, and believing that members of a unit have in common

question

Organizational Culture

answer

how employees perceive the organizations; how it feels to be part of the unit or organization; perceptions may differ and may be accurate or inaccurate

question

Organizational Climate vs. Culture

answer

Climate is the system of symbols and interactions unique to each organization (how the organization thinks, behaves, and believes) while Culture is how employees perceive the organization (how it feels to be part of the organization)

question

Shared Governance

answer

innovative and idealistic organizational structure that empowers employees within the decision-making system (giving nurses more authority and control over nursing practice)

question

Participatory Management

answer

implies that others are allowed to participate in decision making over which someone has control

question

Shared Governance vs. Participatory Management

answer

Shared governance empowers employees to make decisions while participatory management allows employees to participate in decision making, but still has someone who has control and makes final decisions

UTA NURS 4223 – Leadership & Management – Flashcards

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